Journal of midwifery & women's health最新文献

{"title":"Mandala as a New Intervention for Reducing Fear of Childbirth: A Randomized Controlled Trial.","authors":"Tuğba Topcu, Fadime Bayri Bingöl","doi":"10.1111/jmwh.13722","DOIUrl":"https://doi.org/10.1111/jmwh.13722","url":null,"abstract":"<p><strong>Introduction: </strong>Fear of childbirth is common in nulliparous women. More accessible and less costly interventions such as mandala are needed to reduce fear of childbirth. The purpose of this study was to test the efficacy of mandala coloring added to antenatal education to reduce fear of childbirth.</p><p><strong>Methods: </strong>An open, randomized controlled trial with a parallel group design was conducted at a tertiary care hospital in Turkey (ClinicalTrials.gov registration NCT05217368). Nulliparous pregnant women without pregnancy complications, between 24 and 32 weeks' gestation, and with increased fear of childbirth were included in the study. A total of 140 pregnant women were allocated to the intervention (mandala coloring plus antenatal education) and control (antenatal education alone) groups, and 100 participants completed the study. Fear before childbirth was measured with the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A at baseline and after completion of antenatal education with or without mandala coloring. Fear during childbirth was measured with the W-DEQ version B retrospectively within one week of giving birth.</p><p><strong>Results: </strong>At baseline, the intervention and control groups experienced similar fear of childbirth (57.1 vs 57.0; P = .978). After completing antenatal education, the mean fear of childbirth decreased more in the intervention group than in the control group (42.6 vs 50.1; P = .018). In the postpartum period, the intervention group reported less fear during childbirth than the intervention group (68.5 vs 58.0; P = .030). Perinatal outcomes were statistically similar between the 2 groups.</p><p><strong>Discussion: </strong>Adding mandala coloring to antenatal education significantly reduced fear of childbirth before and during birth. More studies examining the effects of mandala coloring on perinatal mental health should be conducted.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preserving the Midwifery Model of Care on a High Acuity Labor and Delivery Unit: Midwives' Perspectives Working in a US Tribal Health System.","authors":"Anjali Madeira, Kimberly Fleming, Megan Webb, Heather Wheelock","doi":"10.1111/jmwh.13716","DOIUrl":"https://doi.org/10.1111/jmwh.13716","url":null,"abstract":"<p><p>Today nearly 9 out of 10 certified nurse-midwives/certified midwives (CNMs/CMs) attend births in hospitals. As the demand for hospital midwifery care has increased over the last quarter century, CNM/CMs' scope of practice has expanded to include care for high-risk patients. Hospital CNMs/CMs are faced with the challenge of balancing support for physiologic birth with an increasingly complex pregnant population cared for in a medicalized ecosystem. Varied perceptions of patient risk and unique philosophies of care can lead to complex discussions between midwives and physicians on the most appropriate care plan for patients. This article shares the experiences and successes of a hospital midwifery practice in the Alaska Native Tribal Health System and explores strategies for promoting the midwifery model of care (MMOC). Midwives in this Tribal Health System experience robust interprofessional collaboration and an organizational focus on patient-centered relationship-based care. Interprofessional collaboration is noted to be among the most critical elements for protecting a MMOC in a hospital setting. Although distinct from one another, the medical and midwifery models can be complementary in the care of high-risk patients, and the Indigenous concept of Two-Eyed Seeing is offered as an approach to integrating the 2 models of care to achieve optimal care for birthing people and their families.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Study of Postpartum Women's Lived Experiences During COVID-19.","authors":"Christine Toledo, Narciso Quidley-Rodriguez, Rosina Cianelli, Natalia Villegas Rodriguez","doi":"10.1111/jmwh.13704","DOIUrl":"https://doi.org/10.1111/jmwh.13704","url":null,"abstract":"<p><strong>Introduction: </strong>According to the Centers for Disease Control and Prevention, the state of Florida became the epicenter of the COVID-19 delta variant during the summer of 2021. There is limited knowledge on how the pandemic impacted postpartum women's lived experiences in the United States. The purpose of the study was to explore the lived experiences of postpartum women living in South Florida during the COVID-19 pandemic and their responses.</p><p><strong>Methods: </strong>A descriptive qualitative study design was used. Study participants included 26 postpartum women living in South Florida who had given birth to a live newborn from March 2020 to May 2022. We used purposeful sampling and social media recruitment methods. Sociodemographic information was collected using REDCap, and live face-to-face in-depth interviews were conducted on Webex using a semistructured questionnaire. Content analysis was used to analyze the research data and develop themes and subthemes.</p><p><strong>Results: </strong>The first central theme, raising an infant during a pandemic, included 3 subthemes: (1) protecting the infant, (2) feeling isolated, and (3) food for thought. The second central theme, maternal needs during a pandemic, included 3 subthemes: (1) mental health needs, (2) support needs, and (3) health care needs.</p><p><strong>Conclusion: </strong>Findings suggest women experienced significant challenges in caring for themselves and their infants during the COVID-19 pandemic. Findings highlight the need for policy reform that secures comprehensive and quality postpartum health care for women that includes mental health screenings.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrative Review of Exclusive Breast Milk Expression.","authors":"Kimberly Rosenbaum, Barbara McAlister","doi":"10.1111/jmwh.13713","DOIUrl":"https://doi.org/10.1111/jmwh.13713","url":null,"abstract":"<p><strong>Introduction: </strong>A growing number of families are using exclusive breastmilk expression to feed their newborns. They need accurate information and support from their providers.</p><p><strong>Methods: </strong>The purpose of this integrative review was to explore the prevalence, characteristics, practices, and outcomes of families who fed exclusively expressed breastmilk to their infants. The electronic databases of CINAHL, Scopus, PubMed, Web of Science, and article reference lists for articles on expressing human milk for infants were searched. Results were filtered to glean published studies between 2012 and 2022, academic journals, human studies, and English language journals while excluding secondary reviews and expert opinions. Both authors screened records within Covidence systematic review management software. Selected studies were evaluated for quality of evidence using the Johns Hopkins Research Evidence Appraisal Tool.</p><p><strong>Results: </strong>Twenty-seven studies were included in this review. Most families who exclusively expressed originally planned to directly breastfeed their newborns and only began pumping after encountering problems. The most frequently recurring theme was that advice from health care personnel was inconsistent. Women described a knowledge deficit and received more help with exclusive expression from informal social media groups than their providers. Prevalence of exclusive breastmilk expression is highest in Asian countries and in the neonatal intensive care unit environment. These women had a shorter duration of human milk feeding and higher likelihood of cessation compared with women who both fed expressed milk and directly breastfed.</p><p><strong>Discussion: </strong>Only recently have breastfeeding researchers begun distinguishing the type of milk (human milk or artificial formula) from the feeding method in their publications. This approach allows clinicians to provide better guidance on the outcomes of each feeding method. As clinicians, we can help families by encouraging them and providing consistently accurate information. Solely feeding expressed human milk is a valid option when the lactating person is unable or unwilling to directly breastfeed.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal And Postpartum Care Experiences Among Black Birthing People In The United States: An Integrative Review.","authors":"Laura M Segovia, Emily Neiman, Shannon L Gillespie, McKenzie K Jancsura, Cindy M Anderson","doi":"10.1111/jmwh.13705","DOIUrl":"https://doi.org/10.1111/jmwh.13705","url":null,"abstract":"<p><strong>Introduction: </strong>Among Black birthing people, high-quality, respectful care throughout pregnancy and postpartum is hindered by distrust, racial discrimination, and unsatisfactory care. The purpose of this integrative review was to examine prenatal and postpartum care experiences among Black birthing people in the United States.</p><p><strong>Methods: </strong>A literature search, spanning from inception through October 6, 2022, across 4 research databases, used a combination of keywords to capture reports on care experiences among Black birthing people. We included quantitative and qualitative studies in the United States with people who self-identified as Black or African American and reported prenatal or postpartum health care experiences. Intrapartum experiences were excluded. All studies were evaluated with the Mixed-Methods Appraisal Tool, National Institutes of Health Study Quality Assessment tool, or Joanna Briggs Institute critical appraisal checklist. Data were analyzed and synthesized using the Joanna Briggs Institute convergent integrated approach to incorporate quantitative and qualitative research.</p><p><strong>Results: </strong>A total of 16 studies published over 27 years met the inclusion criteria. All studies examined the health care experiences of Black birthing people during prenatal or postpartum care. None of the studies focused solely on postpartum care experiences. The 2 most prominent themes were models of care and patient-provider interactions, encompassing both positive and negative experiences. Positive care experiences included collaborative patient-provider interactions, continuity of care, and culturally centered care. Adverse experiences were more frequently noted and involved discriminatory treatment during patient-provider interactions, fragmented care models, and a lack of cultural awareness.</p><p><strong>Discussion: </strong>Black birthing people in the United States report some positive but more negative health care experiences during pregnancy and postpartum care, which may play an important role in health inequities. Promoting prenatal and postpartum care models that provide continuity and are high-quality, collaborative, and culturally centered were identified as high-priority targets to foster patient safety and improve clinical outcomes.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal Care Provider Perspectives on Integrating Clinical Research Into the Clinical Infrastructure.","authors":"Yanqiao Li, Kylea L Liese, Lacey Pezley, Arissara Sawatpanich, Gloria Elam, Katherine Erbe, Lisa Tussing-Humphreys, Mary Dawn Koenig","doi":"10.1111/jmwh.13703","DOIUrl":"10.1111/jmwh.13703","url":null,"abstract":"<p><strong>Introduction: </strong>This study explored perinatal health care providers' perspectives on the recruitment of pregnant participants and integrating clinical research into their practice, with a particular emphasis on the complexities introduced by the COVID-19 pandemic.</p><p><strong>Methods: </strong>From May to September 2021, semistructured interviews were conducted with 10 perinatal health care providers from an urban US health center. The interview transcripts were analyzed using Braun and Clarke's thematic analysis framework, a rigorous method for analyzing qualitative data by identifying, coding, and reporting themes. This approach allowed us to systematically code the data and identify key themes related to recruitment strategies and integration of clinical trials during prenatal care.</p><p><strong>Results: </strong>Barriers to integrating clinical trials into the perinatal infrastructure included pandemic-related restrictions, heavy workloads, time constraints, ineffective communication and coordination, and maintaining the relevance of the research among providers. Facilitators included the use of communication tools, collaboration with multidisciplinary teams and stakeholders, creation of detailed study information for clinic staff, and fostering commitment to supporting research among providers.</p><p><strong>Discussion: </strong>The perspectives of perinatal health care providers uncover barriers and facilitators regarding the recruitment of pregnant individuals for clinical trials and shed light on the unprecedented challenges of research in this population during the COVID-19 pandemic and lessons learned postpandemic. This information can support the development of evidence-based solutions and strategies to improve the recruitment of pregnant individuals, as well as enhance clinical research integration into infrastructure in perinatal health clinics.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycystic Ovary Syndrome as a Key Risk Factor in Pregnancy Outcomes: A Midwifery Perspective from the International Guideline.","authors":"Mahnaz Bahri Khomami","doi":"10.1111/jmwh.13706","DOIUrl":"https://doi.org/10.1111/jmwh.13706","url":null,"abstract":"","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Societal Discrimination, Vigilance, and Patient-Provider Relationships Among Perinatal Women: A Mixed Methods Study.","authors":"Katherine I Tierney, Ellen Wagenfeld-Heintz, Cynthia Bane, Silvia Linares, Megan Sandberg, Drew Moss, Abby Duerst, Claudia Walters, Terra Bautista, Lynette Gumbleton, Catherine L Kothari","doi":"10.1111/jmwh.13700","DOIUrl":"https://doi.org/10.1111/jmwh.13700","url":null,"abstract":"<p><strong>Introduction: </strong>In the United States, maternal mortality is high and patterned by race and socioeconomic status (SES). Patient-provider relationships and societal discrimination have been separately associated with poor maternal outcomes, but it is not clear how such mechanisms may be interrelated. Thus, the present study investigates how societal experiences of discrimination are associated with and manifest in patient-provider relationship quality among perinatal women.</p><p><strong>Methods: </strong>The study uses a mixed methods design with an explanatory-sequential approach. First, a path analysis using structural equation modeling of a cross-sectional representative survey of 244 perinatal women in Kalamazoo County, Michigan, was conducted. Second, a thematic qualitative analysis was conducted of focus groups composed of survey participants (n = 34).</p><p><strong>Results: </strong>In the quantitative analyses, race and SES were associated with experiences of societal discrimination in the expected directions (race: b, 1.87; SE, 0.58; P = .001; SES: b, 2.18; SE, 0.60; P < .001), discrimination positively predicted vigilant behaviors (b, 0.81; SE, 0.15; P < .001), and more vigilant behaviors predicted worse patient-provider relationship quality (b, 0.18; SE, 0.07; P < .001). In the qualitative findings, we found detailed accounts linking provider discrimination, vigilance, and patient-provider relationships among focus groups composed of only women of color (n = 9).</p><p><strong>Discussion: </strong>Overall, the quantitative analyses find support for the conceptual model showing race and SES are associated with societal discrimination, which is associated with vigilant behaviors and, in turn, quality of patient-provider relationships. The qualitative analyses provide preliminary evidence for how these pathways manifest in care settings and demonstrate the importance of establishing trust in patient-provider relationships, especially among women of color.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Music and Sleep Hygiene Interventions for Pregnancy-Related Insomnia: An Online Randomized Controlled Trial.","authors":"Nadia Flensted Hoegholt, Camilla Eva Krænge, Peter Vuust, Morten Kringelbach, Kira Vibe Jespersen","doi":"10.1111/jmwh.13699","DOIUrl":"https://doi.org/10.1111/jmwh.13699","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 50% to 60% of all pregnant women suffer from insomnia during pregnancy. Pregnancy-related insomnia has been associated with severe outcomes for both mother and child postnatally. Currently, the treatment of pregnancy-related insomnia is often neglected due to a lack of suitable treatments. This online assessor-masked randomized controlled trial aimed to evaluate the effectiveness of music listening and sleep hygiene for treating pregnancy-related insomnia.</p><p><strong>Methods: </strong>We recruited first-time pregnant women at the end of the second trimester with a report of poor sleep. Participants in the music and sleep hygiene (MSH) group received standard sleep hygiene advice and were instructed to listen to music daily at bedtime for 4 weeks. They could choose from 6 sleep playlists of different genres. Participants randomized to the sleep hygiene alone (SH) group received standard sleep hygiene only. Primary outcomes were sleep quality measured with the Pittsburgh Sleep Quality Index (PSQI) and insomnia severity measured with the Insomnia Severity Index.</p><p><strong>Clinicaltrials: </strong>gov Identifier: NCT04633395.</p><p><strong>Results: </strong>Among the 98 participants receiving the online intervention, 31 participants in the MSH group (62%) and 40 participants in the SH group (80%) completed the postintervention measurements. Both groups experienced improved sleep quality during the intervention period (PSQI change, -2.10; 95% CI, -3.27 to -0.93; P < .001), with no significant difference between the groups. Similarly, insomnia symptoms were reduced (Insomnia Severity Index change, -3.42; 95% CI, -5.02 to -1.83; P < .001) with no significant difference in the effect between groups. There was a significant difference in adherence to sleep hygiene between the MSH and SH groups (42% vs 8%; P = .007).</p><p><strong>Discussion: </strong>Sleep quality and insomnia severity can be improved in pregnant women with relatively simple interventions like music listening and sleep hygiene advice. These results align with previous research, but larger trials are recommended to support introduction into clinical practice.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participant Personal Characteristics and Adherence to Oral Capsules: A Secondary Analysis of a Randomized Placebo-Controlled Trial of Antenatal Probiotics.","authors":"Lisa Hanson, Kathlyn Albert, Emily Malloy, Maharaj Singh, Mikala Kallay, Ava Brandt, Courtney Morris, Diana Kleber, Marie Forgie","doi":"10.1111/jmwh.13686","DOIUrl":"10.1111/jmwh.13686","url":null,"abstract":"<p><strong>Background: </strong>Adherence to study interventions is critical to the conduct of randomized controlled trials (RCTs). The relationships between participant characteristics and intervention adherence are understudied in pregnant populations. The purpose of this study was to conduct a secondary analysis of adherence to study capsules in a double-masked, placebo-controlled RCT of a probiotic intervention to reduce antenatal Group B Streptococcus colonization, in relationship to participant characteristics.</p><p><strong>Methods: </strong>We analyzed the relationship between capsule adherence rates and demographic characteristics among 81 RCT participants. Categorical variables were reported using counts and percentages, and continuous variables were expressed as means along with their standard deviations. For the univariate analyses, we compared demographic variables with adherence scores. A multivariate linear regression model was used to identify predictors of adherence.</p><p><strong>Results: </strong>Average adherence was similar for control and probiotic group participants (P = .86) Univariate analysis showed that average adherence increased directly with age, education, and income. Participants who were partnered or living with others had higher average adherence compared with those who were single and living alone. Asian and White participants had the highest and Black participants had the lowest average, and there was no difference based on Hispanic ethnicity. Adjusting for all the variables in the regression, participants who identified as Black were significantly less likely to adhere to capsules than White participants, and those who were married or living with partners were more likely to adhere than the single participants.</p><p><strong>Discussion: </strong>Diverse participants are critically important to RCTs. This secondary analysis provides evidence that participant characteristics and the social determinants of health play an important role in adherence to self-administered interventions in RCTs, although more research is needed. Our findings suggest that intentional consideration of RCT participant characteristics may allow for the development and tailoring of strategies to enhance intervention adherence. The study was registered on ClinicalTrials.gov (NCT03696953) on January 10, 2018.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}